DOJ: Fraud settlements hit record $6.8B in 2025, with healthcare a primary focus
The U.S. Department of Justice (DOJ) released data showing 2025 set a record for fraud settlements and judgments achieved through enforcement of the False Claims Act, with authorities saying healthcare remains a “key enforcement” target.
According to the DOJ’s announcement, fraudsters paid out $6.8 billion last year, including reimbursement for damages and punitive awards to both the government and whistleblowers who exposed malfeasance.
The figures, which cut off on September 30, 2025, reveal that 1,297 qui tam lawsuits were brought by plaintiffs last year under the False Claims Act, most of whom are former employees of companies and organizations later found to be potentially in violation of federal regulations
That’s the highest number ever, the DOJ added. The agency also said it opened 401 investigations of its own, a number of which are still pending.
Notably, many DOJ cases are settled out of court, meaning that although companies pay out damages, they are not legally required to admit to wrongdoing.
“The achievements announced today reflect exemplary work by the Department’s dedicated employees to investigate and litigate cases involving fraud against the government and to ensure that America’s taxpayer dollars are used for their intended purpose,” Assistant Attorney General of the Justice Department’s Civil Division, Brett A. Shumate, said in a statement. “The False Claims Act and its whistleblower provisions are crucial tools for ensuring that public funds are spent properly and in the public interest.”
The DOJ said the False Claims Act has now earned a grand total of more than $85 billion in payouts since 1986, when the legislation was significantly reformed and expanded.
Healthcare on the front lines
As a key area of investigative focus, healthcare fraud made up the majority of a record-setting year for the DOJ. The agency revealed that of the $6.8 billion in settlements and judgments, $5.7 billion was “related to matters that involved the healthcare industry,” including recoveries to government healthcare programs, such as Medicare and Medicaid.
Claims made against defendants include overbilling insurance, providing unnecessary care to patients, conspiring with diagnostic companies to bill for medically irrelevant tests, harmful products and more.
The agency said it’s primarily looking into three buckets when it comes to healthcare-related investigations: managed care, prescription drugs and medically unnecessary patient care delivery.
It added that the $5.7 billion is only a measure of False Claims Act recoveries for federal government programs. However, in many of those cases states also benefited, as they share in Medicaid losses.
In July 2025, the DOJ announced it had undertaken the largest healthcare fraud takedown in history, with 324 people charged in schemes that could have cost taxpayers $14.6 billion. Accusations include the unlawful distribution of opioids, submitting false medical claims for reimbursement, telehealth fraud and more.
Many of those cases are pending.
Chad is an award-winning writer and editor with over 15 years of experience working in media. He has a decade-long professional background in healthcare, working as a writer and in public relations.